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Recommended physical activity and depression in Japanese adults
Abstracts / Journal of Science and Medicine in Sport 15 (2012) S1–S33
49 Associations between sitting time and health-related quality of life and psychosocial health among older men J. Vallance 1,∗ , D. Eurich 2 , C. Lavallee 1 , S. Johnson 1 1 2
Athabasca University University of Alberta
Introduction: Population based objective assessments (i.e. accelerometers) indicate that older men (>60 years) have the highest levels of sedentary time with approximately 60% of their waking time engaged in sedentary behavior. Sedentary time has been linked to mortality, type 2 diabetes, and cardio-metabolic markers. No studies have evaluated sedentary time and multidimensional HRQoL among older men. The purpose of this study was to determine associations of total sitting time with health-related quality of life (HRQoL) among older men. Methods: Using a cross-sectional design, older aged men 55 years of age and older from Alberta, Canada completed a mailed survey that assessed HRQoL (RAND-12). Sitting time was assessed using five items validated by Marshall et al. (2010). Participants were asked to estimate how much time they spent sitting each day in the following situations; a) while traveling to and from places, b) while at work, c) while watching television, d) while using a computer at home, and e) at leisure not including television, separately for weekday and weekend. The primary model assessed the association between total sitting time as the independent variable of interest and our dependent variables of interest (physical, mental, and global health component scores of the RAND12). Results: Participants (N=375) averaged 9.3 hours (SD=7) of sitting time (or 557 minutes) for weekday and 8.3 hours (SD=5.2) of sitting time (or 511.6 minutes) for weekend. Quartile (Q) cut-points for weekday total sitting time were <380 (Q1), 380 to <500 (Q2), 500 to <630 (Q3), and >=630 (Q4) minutes. Cut-points for weekend total sitting time were <350 (Q1), 350 to <480 (Q2), 480 to <600 (Q3), and >=600 (Q4) minutes. For weekday, all three adjusted HRQoL models (i.e. physical, mental, and global health) indicated no significant differences in HRQoL indices across weekday sitting time quartiles (all p’s>.32). For weekend, all three adjusted models indicated significant associations. Differences were observed when comparing Q1 and Q4 on physical (Mdiff =2.3, p=0.05), mental (Mdiff =3.4, p<0.05), and global health (Mdiff =2.8, p<0.05). Discussion: While weekday sitting time was not significantly associated with HRQoL domains, weekend sitting time was associated with HRQoL domains when comparing the lowest and highest quartiles. In this sample, older men who reported less time sitting on the weekend also reported more optimal HRQoL indices. http://dx.doi.org/10.1016/j.jsams.2012.11.051 50 Physical activity levels amongst inpatients with Post Traumatic Stress Disorder: Is self-report a valid measure? S. Rosenbaum 1,2 , H. Sherrington 1
van
der
Ploeg 3 , A.
Tiedemann 1,∗ , C.
1
Musculoskeletal Division, The George Institute for Global Health St John of God Hospital 3 Sydney School of Public Health, University of Sydney 2
Introduction: The physical health of people with a mental illness is often compromised, and those with mental health conditions such as Post Traumatic Stress Disorder (PTSD) are often less likely to be physically active then the general population. Hence, it
S21
is important to accurately assess physical activity among inpatients being treated for PTSD. This study aimed to determine the construct validity of the International Physical Activity Questionnaire (IPAQ-short form) for use in PTSD inpatients. Methods: Inpatients of the adult-trauma program at St John of God Hospital in Sydney (Australia) were recruited over a twelve-month period (n=59, 85% male; 49% police officers). Participants wore an Actigraph accelerometer for 7 days, at the end of which participants self completed the IPAQ-short predominantly. Analyses determined the construct validity of the IPAQ against the accelerometer using the Spearman rho correlation coefficients. Results: The Spearman correlation between total physical activity based on the IPAQ and moderate to vigorous physical activity from the questionnaire was 0.462. Compliance with wearing the accelerometer was lower than usual, 20/59 participants (33.89%) recorded 3 or less valid days out of a total of 7, whilst only 8/59 (13.56%) had the maximum 7 valid days. The IPAQ was completed somewhat better, 7/59 (11.86%) were incomplete primarily due to sudden or early discharge, and 8/59 (13.56%) reported values considered erroneously high, which had to be capped as per the IPAQ scoring manual. When stratifying by severity of illness, based on the Health of the Nation Outcome Scale (HoNOS), the Spearman correlation was 0.591 for those with a greater illness severity (HoNOS total ≥21; n=20), and 0.377 for those with lower severity scores (HoNOS total ≤20; n=16). Discussion: The IPAQ short form self-report questionnaire has acceptable construct validity for estimating physical activity participation of inpatients with PTSD. Poor compliance with wearing an objective activity monitor in this population might make the use of supervised self-report questionnaires or interviews more suitable for the assessment of physical activity. http://dx.doi.org/10.1016/j.jsams.2012.11.052 51 Recommended physical activity and depression in Japanese adults K. Ishii ∗ , A. Shibata, K. Oka Faculty of Sport Sciences, Waseda University Background: Depression, a common mental illness, has a high global incidence. Regular physical activity at recommended levels is inversely associated with depression. Therefore, the promotion of engaging physical activity should be a priority for depression prevention. However, this association has not yet been studied in the Japanese population. The present study examines the association between recommended physical activity criteria and depression, and depression score differences between physical activity groups and socio-demographic variables among Japanese adults. Methods: Socio-demographic data (gender, age, educational level, employment status, marital status, living conditions, and household income), the Japanese short version of the International Physical Activity Questionnaire, and the Center for Epidemiologic Studies Depression Scale were used to estimate the participants’ physical activity and depression levels, respectively, via an Internet-based survey. A representative sample of 3,000 Japanese adults answered the survey, stratified by gender and age. The present study followed current Japanese exercise guidelines to categorize respondents as “meeting” or “not meeting” the recommended criteria of 23 metabolic equivalent (MET)-hours per week. Analysis of covariance and two-way univariate analysis of covariance were performed.
S22
Abstracts / Journal of Science and Medicine in Sport 15 (2012) S1–S33
Results: Respondents not meeting the recommendations for physical activity had significantly higher depression scores than those meeting the recommendations (F(1, 1349)=6.82, P=0.009 in men and F(1, 1387)=8.37, P=0.004 in women). Individuals not meeting the recommended criteria had significantly higher depression scores than those meeting the criteria across the following variables: age, marital status, living conditions, and household income in men; and age, marital status, education level, employment status, and household income in women. Men who were unmarried and had low household income levels and women who were young, unmarried, and had lower household income levels had higher depression scores. Discussion: In summary, respondents not meeting the recommendations for physical activity had higher depression scores than those meeting the recommendations among different sociodemographic factors, especially in young adults, the unmarried, and individuals with low household incomes. The present study offers new evidence on the relationship between physical activity and depression in Japan and helps to fill a large gap in the data from nonWestern countries. Since no other study of the Japanese population has been conducted on this topic, the findings of the present study will be important for the future development of intervention strategies for population-based health promotion and will contribute to the promotion of physical activity. http://dx.doi.org/10.1016/j.jsams.2012.11.053 52 A comparison of physical activity context preferences between adults with psychological distress and those without N. Burton ∗ , A. Khan, W. Brown The University of Queensland Introduction: Physical activity can promote well-being and assist in the management of psychological symptoms. To support the development of physical activity opportunities, the aim of this study was to compare physical activity context preferences between mid-aged adults with psychological distress and those without. Methods: This cross-sectional analysis used data from a population-based mail survey with 7670 adults aged 42–67 years conducted in Brisbane, Australia (the HABITAT study). Psychological distress was assessed using the Kessler6, and respondents were categorized as no distress (0–7) or some distress (8–24). Participants indicated the extent to which they agreed or disagreed with a preference for each of 14 physical activity contexts; responses were collapsed into categories of disagree, no preference, or agree. Data were analyzed using multi-level multinomial logistic regression, with adjustment for physical activity level, sex, age, household composition, education, employment status, income, general health, and body mass index. Disagreement with the activity context preference was considered as the reference category. Adjusted odds ratios and 95% confidence intervals are reported. Results: Approximately 12% (n=909) of respondents were categorized as experiencing some psychological distress. Over 70% of distressed respondents preferred activities that can be done alone, can be done close to home, and activities that involve little or no cost. Approximately 60% of distressed respondents had a preference for activities done outdoors and activities that are not just about exercise, and a preference against activities that involve competition. Distressed respondents had higher odds (vs no distress) to agree with a preference for supervised activities (1.64; 1.32–2.03), activities done with people of the same sex (1.41; 1.12–1.78),
and activities done at a fixed time with scheduled sessions (1.32; 1.08–1.62). Distressed respondents also had a lower odds to agree with a preference for vigorous activities (0.80; 0.64–0.99) and activities that are not just about exercise (0.77; 0.60–0.99). There were no significant associations between distress and preferences for activities that can be done alone, are done with people the same age, are done outdoors, are done close to home, are low cost, are with a set routine or format, are team-based, involve competition, or that require skill and practice. Discussion: Mid-aged adults with psychological distress prefer different physical activity contexts than those without distress. Understanding how, where and with whom people prefer to do physical activity can be used to tailor and promote physical activity opportunities. http://dx.doi.org/10.1016/j.jsams.2012.11.054 53 Physical activity is less fun than sex, but better than work T. Olds ∗ , D. Burdon, S. Gomersall, L. Lewis, C. Maher University of South Australia Introduction: The context and attributes of physical activity (such as enjoyment, intensity, environment and timing) can modify its health-related benefits. This study examined adults’ enjoyment of physical activity. Methods: 127 adults (70 F, 35±14 y) completed a computerised use-of-time recall of one 24 h period. For each activity recalled, they were asked how much they enjoyed it on a scale ranging from 0 (“I hated it”) to 10 (“I loved it”). Results: Participants recalled 4525 activity instances, of which 811 were moderate to vigorous physical activity (MVPA). The mean (SD) enjoyment rating for MVPA was 6.3 (1.8) units, below the average rating for all activities of 6.6 (1.7), and considerably below the ratings for sex (9.3), social activities (7.9), eating (7.5) and sleeping (7.4), but above work-related activities (6.0) and household chores (5.4). Enjoyment of MVPA varied with domain, personal characteristics, intensity, companions and time of day. Among domains of MVPA, playing with children and animals (8.7), and sport and exercise (7.8) ranked well above active transport (5.6). Higher enjoyment ratings were associated with greater age and higher exercise intensity (p<0.0001). Physical activity was enjoyed more when done with partners, friends and children (6.8–7.1) than alone (6.2; p=0.04). On weekdays, physical activity was enjoyed least around the hours of 0800 and 1600, and most around 2000. On weekends, enjoyment of physical activity plateaued from 1000 to 1800. Discussion: The enjoyment of physical activity is heavily influenced by its nature and context. This is consistent with studies which have shown that physical activity in certain contexts is not associated with better psychological outcomes. http://dx.doi.org/10.1016/j.jsams.2012.11.055
49 Associations between sitting time and health-related quality of life and psychosocial health among older men J. Vallance 1,∗ , D. Eurich 2 , C. Lavallee 1 , S. Johnson 1 1 2
Athabasca University University of Alberta
Introduction: Population based objective assessments (i.e. accelerometers) indicate that older men (>60 years) have the highest levels of sedentary time with approximately 60% of their waking time engaged in sedentary behavior. Sedentary time has been linked to mortality, type 2 diabetes, and cardio-metabolic markers. No studies have evaluated sedentary time and multidimensional HRQoL among older men. The purpose of this study was to determine associations of total sitting time with health-related quality of life (HRQoL) among older men. Methods: Using a cross-sectional design, older aged men 55 years of age and older from Alberta, Canada completed a mailed survey that assessed HRQoL (RAND-12). Sitting time was assessed using five items validated by Marshall et al. (2010). Participants were asked to estimate how much time they spent sitting each day in the following situations; a) while traveling to and from places, b) while at work, c) while watching television, d) while using a computer at home, and e) at leisure not including television, separately for weekday and weekend. The primary model assessed the association between total sitting time as the independent variable of interest and our dependent variables of interest (physical, mental, and global health component scores of the RAND12). Results: Participants (N=375) averaged 9.3 hours (SD=7) of sitting time (or 557 minutes) for weekday and 8.3 hours (SD=5.2) of sitting time (or 511.6 minutes) for weekend. Quartile (Q) cut-points for weekday total sitting time were <380 (Q1), 380 to <500 (Q2), 500 to <630 (Q3), and >=630 (Q4) minutes. Cut-points for weekend total sitting time were <350 (Q1), 350 to <480 (Q2), 480 to <600 (Q3), and >=600 (Q4) minutes. For weekday, all three adjusted HRQoL models (i.e. physical, mental, and global health) indicated no significant differences in HRQoL indices across weekday sitting time quartiles (all p’s>.32). For weekend, all three adjusted models indicated significant associations. Differences were observed when comparing Q1 and Q4 on physical (Mdiff =2.3, p=0.05), mental (Mdiff =3.4, p<0.05), and global health (Mdiff =2.8, p<0.05). Discussion: While weekday sitting time was not significantly associated with HRQoL domains, weekend sitting time was associated with HRQoL domains when comparing the lowest and highest quartiles. In this sample, older men who reported less time sitting on the weekend also reported more optimal HRQoL indices. http://dx.doi.org/10.1016/j.jsams.2012.11.051 50 Physical activity levels amongst inpatients with Post Traumatic Stress Disorder: Is self-report a valid measure? S. Rosenbaum 1,2 , H. Sherrington 1
van
der
Ploeg 3 , A.
Tiedemann 1,∗ , C.
1
Musculoskeletal Division, The George Institute for Global Health St John of God Hospital 3 Sydney School of Public Health, University of Sydney 2
Introduction: The physical health of people with a mental illness is often compromised, and those with mental health conditions such as Post Traumatic Stress Disorder (PTSD) are often less likely to be physically active then the general population. Hence, it
S21
is important to accurately assess physical activity among inpatients being treated for PTSD. This study aimed to determine the construct validity of the International Physical Activity Questionnaire (IPAQ-short form) for use in PTSD inpatients. Methods: Inpatients of the adult-trauma program at St John of God Hospital in Sydney (Australia) were recruited over a twelve-month period (n=59, 85% male; 49% police officers). Participants wore an Actigraph accelerometer for 7 days, at the end of which participants self completed the IPAQ-short predominantly. Analyses determined the construct validity of the IPAQ against the accelerometer using the Spearman rho correlation coefficients. Results: The Spearman correlation between total physical activity based on the IPAQ and moderate to vigorous physical activity from the questionnaire was 0.462. Compliance with wearing the accelerometer was lower than usual, 20/59 participants (33.89%) recorded 3 or less valid days out of a total of 7, whilst only 8/59 (13.56%) had the maximum 7 valid days. The IPAQ was completed somewhat better, 7/59 (11.86%) were incomplete primarily due to sudden or early discharge, and 8/59 (13.56%) reported values considered erroneously high, which had to be capped as per the IPAQ scoring manual. When stratifying by severity of illness, based on the Health of the Nation Outcome Scale (HoNOS), the Spearman correlation was 0.591 for those with a greater illness severity (HoNOS total ≥21; n=20), and 0.377 for those with lower severity scores (HoNOS total ≤20; n=16). Discussion: The IPAQ short form self-report questionnaire has acceptable construct validity for estimating physical activity participation of inpatients with PTSD. Poor compliance with wearing an objective activity monitor in this population might make the use of supervised self-report questionnaires or interviews more suitable for the assessment of physical activity. http://dx.doi.org/10.1016/j.jsams.2012.11.052 51 Recommended physical activity and depression in Japanese adults K. Ishii ∗ , A. Shibata, K. Oka Faculty of Sport Sciences, Waseda University Background: Depression, a common mental illness, has a high global incidence. Regular physical activity at recommended levels is inversely associated with depression. Therefore, the promotion of engaging physical activity should be a priority for depression prevention. However, this association has not yet been studied in the Japanese population. The present study examines the association between recommended physical activity criteria and depression, and depression score differences between physical activity groups and socio-demographic variables among Japanese adults. Methods: Socio-demographic data (gender, age, educational level, employment status, marital status, living conditions, and household income), the Japanese short version of the International Physical Activity Questionnaire, and the Center for Epidemiologic Studies Depression Scale were used to estimate the participants’ physical activity and depression levels, respectively, via an Internet-based survey. A representative sample of 3,000 Japanese adults answered the survey, stratified by gender and age. The present study followed current Japanese exercise guidelines to categorize respondents as “meeting” or “not meeting” the recommended criteria of 23 metabolic equivalent (MET)-hours per week. Analysis of covariance and two-way univariate analysis of covariance were performed.
S22
Abstracts / Journal of Science and Medicine in Sport 15 (2012) S1–S33
Results: Respondents not meeting the recommendations for physical activity had significantly higher depression scores than those meeting the recommendations (F(1, 1349)=6.82, P=0.009 in men and F(1, 1387)=8.37, P=0.004 in women). Individuals not meeting the recommended criteria had significantly higher depression scores than those meeting the criteria across the following variables: age, marital status, living conditions, and household income in men; and age, marital status, education level, employment status, and household income in women. Men who were unmarried and had low household income levels and women who were young, unmarried, and had lower household income levels had higher depression scores. Discussion: In summary, respondents not meeting the recommendations for physical activity had higher depression scores than those meeting the recommendations among different sociodemographic factors, especially in young adults, the unmarried, and individuals with low household incomes. The present study offers new evidence on the relationship between physical activity and depression in Japan and helps to fill a large gap in the data from nonWestern countries. Since no other study of the Japanese population has been conducted on this topic, the findings of the present study will be important for the future development of intervention strategies for population-based health promotion and will contribute to the promotion of physical activity. http://dx.doi.org/10.1016/j.jsams.2012.11.053 52 A comparison of physical activity context preferences between adults with psychological distress and those without N. Burton ∗ , A. Khan, W. Brown The University of Queensland Introduction: Physical activity can promote well-being and assist in the management of psychological symptoms. To support the development of physical activity opportunities, the aim of this study was to compare physical activity context preferences between mid-aged adults with psychological distress and those without. Methods: This cross-sectional analysis used data from a population-based mail survey with 7670 adults aged 42–67 years conducted in Brisbane, Australia (the HABITAT study). Psychological distress was assessed using the Kessler6, and respondents were categorized as no distress (0–7) or some distress (8–24). Participants indicated the extent to which they agreed or disagreed with a preference for each of 14 physical activity contexts; responses were collapsed into categories of disagree, no preference, or agree. Data were analyzed using multi-level multinomial logistic regression, with adjustment for physical activity level, sex, age, household composition, education, employment status, income, general health, and body mass index. Disagreement with the activity context preference was considered as the reference category. Adjusted odds ratios and 95% confidence intervals are reported. Results: Approximately 12% (n=909) of respondents were categorized as experiencing some psychological distress. Over 70% of distressed respondents preferred activities that can be done alone, can be done close to home, and activities that involve little or no cost. Approximately 60% of distressed respondents had a preference for activities done outdoors and activities that are not just about exercise, and a preference against activities that involve competition. Distressed respondents had higher odds (vs no distress) to agree with a preference for supervised activities (1.64; 1.32–2.03), activities done with people of the same sex (1.41; 1.12–1.78),
and activities done at a fixed time with scheduled sessions (1.32; 1.08–1.62). Distressed respondents also had a lower odds to agree with a preference for vigorous activities (0.80; 0.64–0.99) and activities that are not just about exercise (0.77; 0.60–0.99). There were no significant associations between distress and preferences for activities that can be done alone, are done with people the same age, are done outdoors, are done close to home, are low cost, are with a set routine or format, are team-based, involve competition, or that require skill and practice. Discussion: Mid-aged adults with psychological distress prefer different physical activity contexts than those without distress. Understanding how, where and with whom people prefer to do physical activity can be used to tailor and promote physical activity opportunities. http://dx.doi.org/10.1016/j.jsams.2012.11.054 53 Physical activity is less fun than sex, but better than work T. Olds ∗ , D. Burdon, S. Gomersall, L. Lewis, C. Maher University of South Australia Introduction: The context and attributes of physical activity (such as enjoyment, intensity, environment and timing) can modify its health-related benefits. This study examined adults’ enjoyment of physical activity. Methods: 127 adults (70 F, 35±14 y) completed a computerised use-of-time recall of one 24 h period. For each activity recalled, they were asked how much they enjoyed it on a scale ranging from 0 (“I hated it”) to 10 (“I loved it”). Results: Participants recalled 4525 activity instances, of which 811 were moderate to vigorous physical activity (MVPA). The mean (SD) enjoyment rating for MVPA was 6.3 (1.8) units, below the average rating for all activities of 6.6 (1.7), and considerably below the ratings for sex (9.3), social activities (7.9), eating (7.5) and sleeping (7.4), but above work-related activities (6.0) and household chores (5.4). Enjoyment of MVPA varied with domain, personal characteristics, intensity, companions and time of day. Among domains of MVPA, playing with children and animals (8.7), and sport and exercise (7.8) ranked well above active transport (5.6). Higher enjoyment ratings were associated with greater age and higher exercise intensity (p<0.0001). Physical activity was enjoyed more when done with partners, friends and children (6.8–7.1) than alone (6.2; p=0.04). On weekdays, physical activity was enjoyed least around the hours of 0800 and 1600, and most around 2000. On weekends, enjoyment of physical activity plateaued from 1000 to 1800. Discussion: The enjoyment of physical activity is heavily influenced by its nature and context. This is consistent with studies which have shown that physical activity in certain contexts is not associated with better psychological outcomes. http://dx.doi.org/10.1016/j.jsams.2012.11.055